You are currently browsing the tag archive for the ‘tools for service providers’ tag.

Best Start Resource Centre in Ontario has published a new guide to help facilitators deliver FASD workshops for First Nations women (Download guide). Using culture as its foundation, the guide focuses on promoting health. It also integrates FASD-informed and trauma-informed approaches. It is set up so that facilitators do not have to be an expert on the subject of FASD. The guide provides detailed background information, instructions and resources so that facilitators can fully prepare themselves for delivering the workshops.

planning-for-change-picture

Topics covered in the training guide include:

  • Preparing for the Workshop – covers information like bringing the workshop to communities where there is a concern about the stigma attached to FASD, planning for participant learning differences, as well as handling logistical details.
  • Facilitating the Workshop – includes welcoming activities, giving background about healthy pregnancy, identifying and building on personal strengths, making a plan for health, and drawing on community for support and self care.
  • Resources, Services and Appendices – provided are weblinks to further information and videos; services for pregnancy, parenting, substance use and FASD; participant handouts, and consent forms.

Best Start Resource Centre is well known for its resources for service providers who work with diverse women and families on preconception health, prenatal health and child development.

For more on related topics, see earlier posts:

FASD is a public safety and justice priority for Aboriginal groups, October 23, 2016

Experiences of Northern British Columbian Aboriginal Mothers Raising Adolescents With FASD, January 20, 2014

Pimotisiwin: A Good Path for Pregnant and Parenting Aboriginal Teens, August 26, 2013

“You are not alone. Support is available.” Alcohol and pregnancy campaign designed by and for Aboriginal women in Manitoba, April 10, 2013

Handbook for Aboriginal Alcohol and Drug Work from Australia, January 9, 2013

The Sacred Journey – new resource for service providers who work with First Nations families, August 1, 2012

Aboriginal Comic Book for Pregnant Women and New Moms, May 1, 2012

Pregnancy and Alcohol Brochure for Aboriginal Families, January 30, 2012

Aboriginal midwifery and Poverty & Pregnancy in Aboriginal Communities, August 17, 2011

New Zealand has published an action plan on how best to address FASD. Described as a “whole of government action plan” by Associate Minister of Health, Peter Dunne, Taking Action on Fetal Alcohol Spectrum Disorder: 2016-1019 builds on the best practices being done across communities and service sectors including government policy and partnerships, as well as front line prevention and intervention. According to Fetal Alcohol Network NZ, the government is earmarking an initial 12 million for these efforts, which will increase support and services to women with alcohol and substance use issues.

New Zealand began the process of building the action plan with a discussion document of principles, priorities and action areas. They spent over a year seeking submissions and comments on the plan from professionals, communities, families and whānau (Maori extended family.)  Notable changes to the principles based on those submissions included issues of ethnic and services inequities, as well as stigmatization of women, families and individuals with FASD. The resulting principles defined the core priorities of the plan: prevention, early identification, support and evidence. These priorities framed its action building blocks and designated indications of success of plan outcomes. You can view an analysis of the Ministry of Health action plan submissions here.

By underscoring a collaborative and practical approach, the goal is to make sure that “FASD is prevented and people with FASD and their family/whānau live the best possible lives.”(1) Read more about New Zealand’s efforts:
http://www.health.govt.nz/publication/taking-action-fetal-alcohol-spectrum-disorder-2016-2019-action-plan

To read more about New Zealand’s prevention efforts see these previous posts:

First FEBFAST and Debates about Alcohol Labeling in New Zealand, February 1, 2011


References

  1. FASD Working Group. 2016. Taking Action on Fetal Alcohol Spectrum Disorder: 2016–2019: An action plan. Wellington, NZ: Ministry of Health.

 

 

 

The College of New Caledonia (CNC) has developed a FASD-informed training curriculum to support their FASD informed guide and in response to the expressed needs of three national programs supported by the Public Health Agency of Canada (PHAC) that focus on healthy birth outcomes and healthy outcomes for children.

FASD Trauma Informed guide“Facilitating a Collaborative, Strength-based Approach to FASD Informed Practice:  Western Region BC” was developed following consultations with workers in The Community Action Program for Children (CAPC), the Canada Prenatal Nutrition Program (CPNP), and Aboriginal Head Start (AHS in BC). Workers and administrators wanted help in adjusting their practice of working with women, children and families to include FASD-informed approaches.

These trainings were delivered on-site to approximately 350 people during 2014-2016. Developed by Anne Guarasci and Barb Durban with funding from PHAC, the curriculum, in the form of PowerPoint presentations, has been refined for distribution and consists of three separate presentations each with a particular focus, but all include a primer on FASD including current diagnostic terminology.

1. “Supporting Marginalized Parents who may have FASD” — This presentation focuses on what causes FASD, how it is diagnosed, and who is at risk; the complex nature of prevention and why a holistic, relational approach is required; behavioural and cognitive cues that may indicate FASD; and, the fundamentals of an FASD-informed practice.

Empower guide2. “Strategies and Structures for Supporting Marginalized Women and Families who may have FASD” — Participants explore practices and communication skills that empower and support clients and build relationships; examine individual and agency perceptions, policies and structures in order to reduce barriers to relationship and services for clients; and, develop FASD-specific communication strategies. Client “compliance” issues are re-examined within the context of brain functioning. FASD diagnostic terminology and pathways to access assessment and diagnosis are reviewed.

3. “FASD Prevention” — Using a FASD-informed approach as described in CNC guides (1,2) and the work of Deb Rutman (3), this training builds on the 4 levels of prevention of FASD in Canada (4): awareness and health promotion; brief counseling with women and girls of childbearing age; specialized prenatal support; and postpartum support.  How FASD-informed and trauma-informed approaches overlap is explored along with many strategies for working with women, including those who may have FASD, such as building relationships and reducing barriers through reflective practice, Motivational Interviewing, harm reduction, and individualized services.

The FASD-informed practice training curricula is intended for training of program coordinators and administrators, new frontline workers and seasoned workers who may benefit from a refresher. A year-long evaluation of the training was conducted by Deborah Rutman, and the results will be available for presentation in this blog space, in the next few months.

For more about FASD-informed work, see earlier posts:


REFERENCES/SUGGESTED READING

  1. Guarasci, Anne (2013). FASD Informed Practice for Community Based Programs. Burns Lake, BC: College of New Caledonia – Lakes District Campus.
  2. Guarasci, Anne (2011). Empowering Front-Line Staff and Families Through a Collection of Lived Experiences: Supporting Women Who Have Fetal Alcohol Spectrum Disorder (FASD) Behaviours and Characteristics and/or Other Related Disabilities. Burns Lake, BC: College of New Caledonia – Lake District Campus.
  3. Rutman, D. (2011). Substance using women with FASD and FASD prevention: Voices of women with FASD: Promising approaches in substance use treatment and care for women with FASD. Victoria, BC: University of Victoria.
  4. Poole, Nancy A. (2008). Fetal Alcohol Spectrum Disorder (FASD) Prevention: Canadian Perspectives. Public Health Agency of Canada: Ottawa, ON.

 

For the last four years, HerWay Home in Victoria, BC, has been providing outreach, medical and social services to pregnant and parenting women with difficult lives in a one-stop supportive environment. On June 23 from 9:00-10:00 a.m. PST, there will be a free webinar to share the results of a first-phase evaluation of HerWay.

Deborah Rutman and Carol Hubberstey of Nota Bene Consulting, and Nancy Poole of BC Centre of Excellence for Women’s Health will discuss lessons learned and promising practices, and lead a discussion on working with pregnant and parenting women affected by substance use, violence and mental health issues. With its child-focused, women-centred and family focused approach, HerWay Home encourages positive parenting and healthy outcomes for children and women.

Click here for more information and register by June 20th at http://fluidsurveys.com/surveys/bccewh/herway-home-evaluation-webinar/

To learn more about HerWay home and similar programs, see these previous postings:

 

NDARC Guide

This new resource from the National Drug & Alcohol Research Centre, University of New South Wales, Australia, is designed for all primary health care professions who see women in a broad range of health care service settings during the course of their practice.

The best practices guide builds on the evidence for providing coordinated, supportive and comprehensive care to pregnant women who use substances by providing a model for reducing the harm from alcohol and substance for women and their babies. See page 12 of this guide for a clearly charted overview of how physicians and other health care practitioners can support withdrawal, do psycho-social and nutritional interventions, and address barriers to care for pregnant women.

The model acknowledges the interconnections that impact a woman’s use of substances during pregnancy – including domestic violence, mental health, smoking, and stigma – and provides a guide for identifying risk and next steps for further assessment, support and/or treatment. See page 9 for a view of how identification differs for women who are pregnant, planning a pregnancy, or not planning a pregnancy.

It also moves beyond normal referral and coordination practices by using a holistic assessment process and designating a case coordinator or clinical lead to ensure “assertive follow-up.” Assertive follow-up consists of: making sure women are supported during pregnancy and birth; keeping mothers and their babies in the hospital so that post-birth assessments for mother and child can be done and plans for support and services are in place; providing breastfeeding, safe sleeping, parenting skills and contraception support; as well as, interfacing with partners, family members, and community agencies in support of the woman and her child.  See page 16 for more discussion on assertive follow-up and pages 19-20 for “Addressing barriers to care”.

Although the extensive resources that are included in this guide are geared for practitioners in Australia, many of them provide topic-specific information that practitioners everywhere may find helpful. See pages 24-27 for website links.

For more on screening in primary care settings, see previous posts:

For more on FASD prevention in Australia, see previous posts:

 

 

 

 

Image credit: Shallom Johnson, via flickr (http://www.flickr.com/photos/shallom/376823742/)

Image credit: Shallom Johnson, via flickr

The College of New Caledonia in Burns Lake, British Columbia has developed a number of courses and programs for those who provide supports and services to individuals affected by prenatal alcohol exposure and women at risk of alcohol and drug use during pregnancy. (Check out a previous post on a resource developed by the College on Supporting Women with FASD who are Pregnant or Parenting, January 17, 2012).

The College offers a fully online post diploma program as well as stand-alone courses in FASD. Check out the list of course offerings for January and February 2013. And, remember, as the courses are online, they can be taken anywhere.

For more information, visit the website here or e-mail lakesonline@cnc.bc.ca.

Course Offerings Winter 2013

FASD 301 – Fundamentals and Professional Implications (Feb 6, 2013)

FASD 300 – Support Strategies (Feb 6, 2013)

FASD 305 –  Brain and Behaviour(Feb 27, 2013)

FASD 325 – Developmental Disabilities (Jan 23, 2013)

FASD 260 – Overview of FASD (Jan 16 & Feb 6, 2013)

 

Handbook Cover

“The Handbook for Aboriginal Alcohol and Drug Work is a practical tool written for Aboriginal drug and alcohol workers, mental health workers and others working in this field. It offers a detailed look at alcohol and drug work from clinical, through to prevention, early intervention and harm reduction. This handbook is also likely to help people working to improve policy and those advocating for change.

The idea for it came from workers all over Australia. They told us that they needed an easy to use handbook that can help them respond to the range of alcohol and drug issues they face every day. They also told us that such a book needs to take into account the complex challenges facing workers when helping clients, their families and, sometimes, whole communities.”

This plain language, evidence-based guide was created in partnership between the University of Sydney and Aboriginal and non-Aboriginal agencies and health professionals. Four of the six editors are Aboriginal.

It covers alcohol and drug use as well as a whole range of other issues, including child protection notifications, legal issues, working with clients without housing, mental health and polydrug use, and community-wide approaches.

Chapter 2 focuses on alcohol and Chapter 16 focuses on Special situations, settings, and groups, including pregnancy, breastfeeding and early childhood. It discusses the use of brief intervention and counselling approaches in the context of alcohol and pregnancy. It also has sections covering Neonatal Abstinence Syndrome, Alcohol use in pregnancy and Foetal Alcohol Spectrum Disorders.

The handbook was first distributed to alcohol and drug professionals from around Australia at the National Indigenous Drug and Alcohol Conference in Western Australia in June 2012.

The project started in 2010 with a grant from the Foundation for Alcohol Research and Education (FARE) and continued with the support of the NSW Ministry of Health.

The handbook is available online.

SBIR - Home

Alcohol Screening, Brief Intervention and Referral: Helping Patients Reduce Alcohol-related Risks and Harms is a resource for Canadian family physicians, nurse practitioners and other healthcare professionals developed by the College of Family Physicians of Canada and the Canadian Centre on Substance Abuse.

The online resource, available in both English and French, uses a three-step alcohol screening, brief intervention, and referral process. The resource section includes information on seven sub-populations, including women, alcohol and pregnancy, and alcohol and breastfeeding.

Research evidence supports screening and brief interventions for alcohol misuse as efficacious and cost-effective in a variety of settings.

There are a range of screening tools out there (see posts listed below for more); this resource incorporates Canada’s Low-Risk Alcohol Drinking Guidelines which were released in November 2011.

SBIR Clinical Guide

For more on screening in primary care settings, see previous posts:

Mixing Alcohol and Breastfeeding brochure

In February 2011, Best Start Resource Centre conducted an online survey with parents across Ontario to examine awareness and behaviours regarding breastfeeding and alcohol use.

The researchers found that most women drank little or no alcohol when breastfeeding:

  • 64% did not drink alcohol while breastfeeding
  • 27% drank less than 1 drink a week.
  • 5% drank 1 to 3 drinks per week
  • 4% drank 4 to 6 drinks per week

Most women stopped drinking or reduced the amount that they drank while breastfeeding.

  • 57% stopped drinking altogether
  • 26% reduced the amount of alcohol they drank
  • 18% did not change their drinking habits

Breastfeeding and alcohol survey cover

Women were split on the impact of alcohol use on their decision to feed their baby:

  • 48% felt that drinking alcohol did not impact their decision about how to feed their baby
  • 39% felt that alcohol use did impact their decision on how to feed their baby

In general, the survey showed that:

  • Women with higher incomes had higher levels of alcohol use
  • Women with higher incomes were less likely to stop drinking while breastfeeding

Best Start Resource Centre with the support of the Liquor Control Board of Ontario (LCBO) has created a new brochure for mothers and their partners to help them make an informed choice when it comes to drinking alcohol while breastfeeding.

The Centre has also created a printer-ready handout with information and tips for expectant parents about alcohol use in pregnancy which are available in English, French, Arabic, Cree, Ojibway, Hindi, Punjabi, Tamil, Urdu, Chinese, Spanish, and Tagalog.

alcohol_pregnancy_EN_Page_1

View more resources on alcohol and pregnancy on the Best Start Resource Centre website here.

Reference

Best Start Resource Centre. (2012). Breastfeeding and Alcohol Use: Parent Knowledge and Behaviours in Ontario, 2011. Toronto, Ontario, Canada.

The term “cultural safety” is popping up in all sorts of fields these days, ranging from law to education to social policy. It’s also a term connected with a growing number of FASD support programs, such as the Alberta Parent-Child Assistance Program (PCAP) and the FASD Key Worker and Parent Support Program in British Columbia, which include cultural safety as part of the program framework.

So, what is cultural safety? Cultural safety is still a relatively new term in the Canadian context, but it first evolved out of nursing practice in New Zealand with regards to health care for Maori people. It was suggested that in order to provide quality care for people from different ethnicities and cultures that nurses needed to provide care within the cultural values and norms of the patient.

In Canada, the concept is often used to describe an approach to healthcare that recognizes the conditions that Aboriginal people experience today as a result of a history of colonization, residential schools, and other practices of cultural and social assimilation. This has resulted in a lack of trust and understanding between health care providers and patients and power imbalances that affect care and treatment. Culturally unsafe practices can be considered “any actions that diminish, demean, or disempower the cultural identity and well-being of an individual.”

Cultural safety can be a tool for understanding relationships between health care providers and patients, for analyzing organizational practices, and developing policies that support healing and self-determination.

When cultural safety does not exist, we see issues like the reluctance of individuals to visit mainstream health facilities even when services are needed (and a subsequent discussion by programmers about the “low utilization” of available services by Aboriginal people), inappropriate discussions about the “non-compliance” of individuals with referrals and recommendations, and feelings of fear, disrespect and alienation.

When we apply cultural safety to FASD prevention, we start to recognize things like how:

  • FASD is a medical diagnostic label based on a Western bio-medical model; FASD prevention interventions are based on this same bio-medical model of care
  • FASD continues to be described in mainstream media as a problem primarily in Aboriginal communities
  • Discussions of FASD often build on the historical ‘deficit’ view of Aboriginal people and, in particular, of Aboriginal women as ‘deficit’ mothers
  • The solutions to preventing FASD still continue to focus on addressing alcohol use during pregnancy and do not recognize the historical relationships between colonization, trauma, and alcohol use
  • FASD prevention frequently views alcohol use in pregnancy as an act by an individual women that must be targeted with various interventions (e.g., awareness campaigns and screening by health care providers) and ignores strategies that focus on families and communities (e.g., policies to redress residential schools or addictions programs that include a cultural component on intergenerational trauma)

There’s a growing number of resources on cultural safety available on-line. You can take a look at the resources below as well as the National Aboriginal Health Organization website and the National Native Addictions Partnership Foundation website.

 

References

Brascoupe, S. (2009). Cultural Safety:  Exploring the Applicability of the Concept of Cultural Safety to Aboriginal Health and Community Wellness.  The Journal of Aboriginal Health.  Ottawa: National Aboriginal Health Organization. Download free full-text here.

FASD Network Action Team on FASD Prevention from a Women’s Health Determinants Perspective. (2010). 10 Fundamental components of FASD prevention from a women’s health determinants perspective.

Gerlach, Alison J. (2012). A critical reflection on the concept of cultural safety. Canadian Journal of Occupational Therapy, 79(3): 151-158.

Indigenous Physicians Association of Canada and The Association of Faculties of Medicine of Canada.  (2009). First Nations, Inuit, Metis Health Core Competencies: A Curriculum Framework for Undergraduate Medical Education.

National Aboriginal Health Organization. (2008).  Cultural Competency and Safety: A Guide for Health Care Administrators, Providers and Educators. Ottawa, ON.

Tait, Caroline L. (2008) Ethical Programming Towards a Community-Centered Approach to Mental Health and Addiction Programming in Aboriginal communities. Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health, 6(1), 29-60. Download free full-text from here.

Overview: Four Levels of FASD Prevention

Information Sheet: What Men Can Do To Prevent FASD

Archives

Categories